Abstract
Civil Society Proceeding for Public Hospitals Reform at District Level This study was conducted in collaboration in the search of excellence community hospital for the whole community, strategic partnership was apppraached through all media channels and also direct marketing by sending 7,771 letters to all sectors at all levels for help proposing a delighted community hospital. Voluntary basis of the hospitals was concerned. Self-assessment report by executives (60 applied-hospital: 503 non applied) and core personnel (725: 1185), and external evaluation by district health officers (652:1078) and community leaders (225:334) were used in combination including double teams sites at the end. Eighty four out of 714 hospitals were proposed a champion, 60 hospitals joined, and 23 were defined as highly effective, 5 entered the third round, and were distinct performance. The study results revealed that, community hospitals took care of 41 millon people and covered 90.26 percent of all districts with doctor per population 1:19,038; and 32.89% morbidity rate was found with average 2.67 visits per patient. Increasing trend of inpatient admission and bed used were indentified. Financial stability was assumed through revenue and expense ratio and current ratio. Most of critical success factors(CSFs) and key performance indicators(KPIs), showed higher mean scored rating by applied group than those non applied with statistical significant differences. However, community problem-solving and involvement activities had low mean scores for both groups. Effective coordination and good image were recognized by district health officers and community leaders except rating for participation in health service organization as low. Those applied hospital were received higher mean scores than non applied significantly. In conclusion, responses of civil society were fair as the existing circumstance, and high active response from health sector at all levels particularly community hospitals. At least 23 hospitals showed strong leadership for pursuing development and act as role models. Stage for sharing their visions, experiences, and success result should be available for continuous learning and deployment. Community or comprehensive health care accreditation should also be institutional at national level.
